Healthcare Provider Details

I. General information

NPI: 1871473132
Provider Name (Legal Business Name): BRANDYWINE CENTER FOR AUTISM, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/05/2025
Last Update Date: 09/05/2025
Certification Date: 09/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1035 W STEIN HWY
SEAFORD DE
19973-1146
US

IV. Provider business mailing address

510 PHILADELPHIA PIKE
WILMINGTON DE
19809-2100
US

V. Phone/Fax

Practice location:
  • Phone: 302-327-9215
  • Fax: 320-348-9028
Mailing address:
  • Phone: 302-327-9215
  • Fax: 302-348-9028

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number
License Number State

VIII. Authorized Official

Name: VALPRESIOUS HAM
Title or Position: OPERATIONS DIRECTOR
Credential: CPPM
Phone: 302-327-9215